|
IV infusion therapy/prophylaxis/diagnosis each additional 1 hour
|
$104.10 |
$104.10 |
$104.10 |
$155.00
|
|
IV infusion therapy/prophylaxis/diagnosis initial up to 1 hour
|
$235.43 |
$235.43 |
$235.43 |
$460.85
|
|
IV njx tst vasc flo flap/grf
|
$5,339.00 |
$5,339.00 |
$5,339.00 |
$469.93
|
|
Jak2 targeted sequence analysis
|
$203.72 |
$203.72 |
$203.72 |
$378.30
|
|
Jaw arthroscopy/surgery
|
$5,339.00 |
$5,339.00 |
$5,339.00 |
$3,839.54
|
|
Jaw arthroscopy/surgery
|
$5,339.00 |
$5,339.00 |
$5,339.00 |
$3,839.54
|
|
Jejunstmy tube plcmt
|
$5,339.00 |
$5,339.00 |
$5,339.00 |
$2,244.82
|
|
John cunningham antibody
|
$18.58 |
$18.58 |
$18.58 |
$48.57
|
|
Keratoprosthesis
|
$5,339.00 |
$5,339.00 |
$5,339.00 |
$9,103.00
|
|
Ketamine and metabolite screen - quest
|
$59.63 |
$59.63 |
$59.63 |
$68.15
|
|
Ketogenic steroids fract
|
$17.02 |
$17.02 |
$17.02 |
$79.54
|
|
Ketone body(s) beta-hydroxybutyrate quantitative
|
$8.99 |
$8.99 |
$8.99 |
$56.61
|
|
Kidney endoscopy
|
$5,339.00 |
$5,339.00 |
$5,339.00 |
$4,881.00
|
|
Kidney endoscopy
|
$5,339.00 |
$5,339.00 |
$5,339.00 |
$5,098.80
|
|
Kidney endoscopy
|
$5,339.00 |
$5,339.00 |
$5,339.00 |
$3,817.53
|
|
Kidney endoscopy
|
$5,339.00 |
$5,339.00 |
$5,339.00 |
$5,555.79
|
|
Kidney endoscopy & biopsy
|
$5,339.00 |
$5,339.00 |
$5,339.00 |
$5,110.00
|
|
Kidney endoscopy & biopsy
|
$5,339.00 |
$5,339.00 |
$5,339.00 |
$3,817.53
|
|
Kidney endoscopy & treatment
|
$5,339.00 |
$5,339.00 |
$5,339.00 |
$6,311.00
|
|
Kidney endoscopy & treatment
|
$5,339.00 |
$5,339.00 |
$5,339.00 |
$5,419.00
|
|
Kidney endoscopy & treatment
|
$5,339.00 |
$5,339.00 |
$5,339.00 |
$5,339.00
|
|
Kidney endoscopy & treatment
|
$5,339.00 |
$5,339.00 |
$5,339.00 |
$4,881.00
|
|
Kidney imag w/bld flow multi
|
$594.10 |
$594.10 |
$594.10 |
$1,566.50
|
|
Kidney img w/bldflw sgl without rx
|
$432.43 |
$432.43 |
$432.43 |
$1,468.04
|
|
Kidney (Retroperitoneal) Ultrasound (complete)
|
$206.55 |
$206.55 |
$206.55 |
$668.25
|
|
Kit gene analys d816 variant
|
$137.36 |
$137.36 |
$137.36 |
$355.00
|
|
Kit omnigraft 2.5x2.5cm dermal regeneration matrix - q4105-cost per sq cm
|
$56.51 |
$56.51 |
$56.51 |
$3,877.17
|
|
Kit sound processor cochlear osia 2
|
$2,761.02 |
$2,761.02 |
$2,761.02 |
$10,472.03
|
|
Knee Arthroscopy (Cartilage Repair)
|
$5,339.00 |
$5,339.00 |
$5,339.00 |
$3,839.54
|
|
Knee arthroscopy/drainage
|
$5,339.00 |
$5,339.00 |
$5,339.00 |
$3,839.54
|
|
Knee arthroscopy dx
|
$5,339.00 |
$5,339.00 |
$5,339.00 |
$3,839.54
|
|
Knee Arthroscopy (Meniscus Repair)
|
$5,339.00 |
$5,339.00 |
$5,339.00 |
$3,839.54
|
|
Knee arthroscopy/surgery
|
$5,339.00 |
$5,339.00 |
$5,339.00 |
$2,834.77
|
|
Knee arthroscopy/surgery
|
$5,339.00 |
$5,339.00 |
$5,339.00 |
$2,974.01
|
|
Knee arthroscopy/surgery
|
$5,339.00 |
$5,339.00 |
$5,339.00 |
$3,839.54
|
|
Knee arthroscopy/surgery
|
$5,339.00 |
$5,339.00 |
$5,339.00 |
$3,839.54
|
|
Knee arthroscopy/surgery
|
$5,339.00 |
$5,339.00 |
$5,339.00 |
$3,839.54
|
|
Knee arthroscopy/surgery
|
$5,339.00 |
$5,339.00 |
$5,339.00 |
$3,839.54
|
|
Knee arthroscopy/surgery
|
$5,339.00 |
$5,339.00 |
$5,339.00 |
$3,839.54
|
|
Knee arthroscopy/surgery
|
$5,339.00 |
$5,339.00 |
$5,339.00 |
$3,839.54
|
|
Knee arthroscopy/surgery
|
$5,339.00 |
$5,339.00 |
$5,339.00 |
$3,839.54
|
|
Knee arthroscopy/surgery
|
$5,339.00 |
$5,339.00 |
$5,339.00 |
$4,137.60
|
|
Knee arthroscopy/surgery
|
$5,339.00 |
$5,339.00 |
$5,339.00 |
$3,839.54
|
|
Knee arthroscopy/surgery
|
$5,339.00 |
$5,339.00 |
$5,339.00 |
$3,594.44
|
|
Knee arthroscopy/surgery
|
$5,339.00 |
$5,339.00 |
$5,339.00 |
$5,419.00
|
|
Knee arthroscopy/surgery
|
$5,339.00 |
$5,339.00 |
$5,339.00 |
$7,807.24
|
|
Knee arthroscopy/surgery
|
$5,339.00 |
$5,339.00 |
$5,339.00 |
$10,477.98
|
|
Kras gene addl variants
|
$212.58 |
$212.58 |
$212.58 |
$346.45
|
|
Kras gene variants exon 2
|
$212.58 |
$212.58 |
$212.58 |
$495.00
|
|
Labioplasty 56800
|
$5,339.00 |
$5,339.00 |
$5,339.00 |
$3,762.53
|
|
Lactate dehydrogenase (ldh)
|
$6.64 |
$6.64 |
$6.64 |
$53.30
|
|
Lactic acid
|
$12.73 |
$12.73 |
$12.73 |
$102.90
|
|
Lactoferrin fecal qualitative
|
$21.67 |
$21.67 |
$21.67 |
$88.40
|
|
Lactoferrin fecal quant
|
$21.59 |
$21.59 |
$21.59 |
$106.10
|
|
Lam facetec & foramot crv
|
$5,339.00 |
$5,339.00 |
$5,339.00 |
$7,807.24
|
|
Lam facetec & foramot lumbar
|
$5,339.00 |
$5,339.00 |
$5,339.00 |
$7,907.11
|
|
Lam facetec & foramot thrc
|
$5,339.00 |
$5,339.00 |
$5,339.00 |
$6,839.00
|
|
Lamie excise intrspinl lesion thrc 63266
|
$5,339.00 |
$5,339.00 |
$5,339.00 |
$6,416.80
|
|
Laminotomy single cervical
|
$5,339.00 |
$5,339.00 |
$5,339.00 |
$7,907.11
|
|
Laminotomy single lumbar
|
$5,339.00 |
$5,339.00 |
$5,339.00 |
$7,807.24
|
|
Laparo ablate liver tumor rf
|
$5,339.00 |
$5,339.00 |
$5,339.00 |
$10,948.04
|
|
Laparo ablate renal cyst
|
$5,339.00 |
$5,339.00 |
$5,339.00 |
$9,367.23
|
|
Laparo ablate renal mass
|
$5,339.00 |
$5,339.00 |
$5,339.00 |
$11,523.76
|
|
Laparo-asst vag hysterectomy
|
$5,339.00 |
$5,339.00 |
$5,339.00 |
$6,376.26
|
|
Laparo cholecystectomy/explr
|
$5,339.00 |
$5,339.00 |
$5,339.00 |
$6,637.99
|
|
Laparo cholecystectomy/graph
|
$5,339.00 |
$5,339.00 |
$5,339.00 |
$7,220.90
|
|
Laparo drng lymphocele 49323
|
$5,339.00 |
$5,339.00 |
$5,339.00 |
$6,311.00
|
|
Laparo ligate spermatic vein
|
$5,339.00 |
$5,339.00 |
$5,339.00 |
$6,457.82
|
|
Laparo-myomectomy complex
|
$5,339.00 |
$5,339.00 |
$5,339.00 |
$6,839.00
|
|
Laparo new ureter/bladder
|
$5,339.00 |
$5,339.00 |
$5,339.00 |
$10,689.72
|
|
Laparo new ureter/bladder
|
$5,339.00 |
$5,339.00 |
$5,339.00 |
$7,975.19
|
|
Laparo partial nephrectomy
|
$5,339.00 |
$5,339.00 |
$5,339.00 |
$9,363.13
|
|
Laparo proc abdm/per/oment 49329
|
$5,339.00 |
$5,339.00 |
$5,339.00 |
$6,622.75
|
|
Laparoscope proc rectum
|
$5,339.00 |
$5,339.00 |
$5,339.00 |
$6,463.42
|
|
Laparoscopic myomectomy
|
$5,339.00 |
$5,339.00 |
$5,339.00 |
$6,376.26
|
|
Laparoscopic salpingostomy 58673
|
$5,339.00 |
$5,339.00 |
$5,339.00 |
$5,214.15
|
|
Laparoscopy aspiration
|
$5,339.00 |
$5,339.00 |
$5,339.00 |
$5,855.00
|
|
Laparoscopy biopsy
|
$5,339.00 |
$5,339.00 |
$5,339.00 |
$5,954.23
|
|
Laparoscopye procstom 43659
|
$5,339.00 |
$5,339.00 |
$5,339.00 |
$6,827.25
|
|
Laparoscopy excise lesions
|
$5,339.00 |
$5,339.00 |
$5,339.00 |
$6,376.26
|
|
Laparoscopy fundoplasty
|
$5,339.00 |
$5,339.00 |
$5,339.00 |
$6,311.00
|
|
Laparoscopy gastrostomy
|
$5,339.00 |
$5,339.00 |
$5,339.00 |
$4,384.42
|
|
Laparoscopy lymphadenectomy
|
$5,339.00 |
$5,339.00 |
$5,339.00 |
$11,378.21
|
|
Laparoscopy lymphadenectomy
|
$5,339.00 |
$5,339.00 |
$5,339.00 |
$9,372.17
|
|
Laparoscopy lymph node biop
|
$5,339.00 |
$5,339.00 |
$5,339.00 |
$6,311.00
|
|
Laparoscopy lysis
|
$5,339.00 |
$5,339.00 |
$5,339.00 |
$5,057.88
|
|
Laparoscopy orchiectomy
|
$5,339.00 |
$5,339.00 |
$5,339.00 |
$5,110.00
|
|
Laparoscopy orchiopexy
|
$5,339.00 |
$5,339.00 |
$5,339.00 |
$6,457.82
|
|
Laparoscopy pyeloplasty
|
$5,339.00 |
$5,339.00 |
$5,339.00 |
$11,523.76
|
|
Laparoscopy remove adnexa
|
$5,339.00 |
$5,339.00 |
$5,339.00 |
$6,904.15
|
|
Laparoscopy splenectomy
|
$5,339.00 |
$5,339.00 |
$5,339.00 |
$6,708.00
|
|
Laparoscopy surg colpopexy
|
$5,339.00 |
$5,339.00 |
$5,339.00 |
$7,299.07
|
|
Laparoscopy tubal block 58671
|
$5,339.00 |
$5,339.00 |
$5,339.00 |
$4,881.00
|
|
Laparoscopy ureterolithotomy
|
$5,339.00 |
$5,339.00 |
$5,339.00 |
$5,794.33
|
|
Laparoscopy vagus nerve
|
$5,339.00 |
$5,339.00 |
$5,339.00 |
$5,855.00
|
|
Laparoscopy vagus nerve
|
$5,339.00 |
$5,339.00 |
$5,339.00 |
$5,855.00
|
|
Laparo sling operation 51992
|
$5,339.00 |
$5,339.00 |
$5,339.00 |
$5,419.00
|
|
Laparo urethral suspension
|
$5,339.00 |
$5,339.00 |
$5,339.00 |
$6,457.82
|
|
Laparo-vag hyst incl t/o
|
$5,339.00 |
$5,339.00 |
$5,339.00 |
$7,595.42
|
|
Laparo-vag hyst w/t/o compl
|
$5,339.00 |
$5,339.00 |
$5,339.00 |
$6,311.00
|
